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General NPI Number Information
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NPI Number | 1457500787
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Entity Type | Individual
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Provider Name | SHELLY H TIEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2008
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 2424 N WYATT DR FL 2
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City | TUCSON
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State | AZ
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Zip | 85712-6115
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Country | US
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Telephone | 520-392-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 2424 N WYATT DR STE 260
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City | TUCSON
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State | AZ
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Zip | 85712-6118
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Country | US
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Telephone | 520-795-0549
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Fax | 520-795-0354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 55482
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 036.128275
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | 65210
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | U8599
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License Number State | TX
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